Objective: To investigate the influence of laparoscopic-assisted transanal endoscopic total mesorectal excision (TME) on postoperative anal function in treatment of rectal cancer. Methods: Seventy-five patients with mid/low rectal cancer undergoing TME during May 2010 to January 2014 were selected. Of the patients, 23 cases received laparoscopic-assisted transanal endoscopic approach (transanal endoscopic group), 20 cases underwent open surgery (open surgery group) and 32 cases had laparoscopic procedure (laparoscopic group). The general surgical variables among the three groups were compared, and the function of the anus after operation of the three groups of patients was evaluated by using Wexner’s and Xu Zhongfa’s scoring system, respectively. Results: Compared with either open surgery group or laparoscopic group, the intraoperative blood loss was reduced, and time to first postoperative flatus was shortened, but the operative time was prolonged in transanal endoscopic group (all P<0.05). At one month after operation, both score by Wexner’s scoring system and good rate by Xu Zhongfa’s scoring system in transanal endoscopic group were lower than those in open surgery group or laparoscopic group (all P<0.05), but both of which showed no significant difference among the three groups at 3, 6 and 12 months after operation (all P>0.05). Conclusion: Compared with open and laparoscopic TME, the recovery of anal function after laparoscopic-assisted transanal endoscopic TME is poor for a short period of time, but has no obvious difference at a later period, and this procedure is more minimally invasive with fast postoperative recovery.